Before having coronary artery bypass grafting (CABG), a person must undergo thorough preparations and various tests to ensure the surgery is safe and suitable for them. These tests help the doctor’s team assess if CABG is the right option for the individual and if they are physically ready for the procedure.  These tests may include, but are not limited to:

• Electrocardiogram (ECG)
• Echocardiogram
• Exercise stress test
• Nuclear cardiac stress test
• Cardiac catheterization
• X-ray angiography or computed tomography (CT) scan angiography
• Coronary calcium scan
• Lab tests to analyze cholesterol, blood sugar, and other factors
• Urine tests to assess kidney function
• The doctor will also review the medications, advising which to continue and which to stop before the surgery. They might change the patient’s medication regimen or start on new medications as necessary.
• Preparation for the surgery will be discussed, including arrangements for home support, dietary guidelines, personal grooming, and bathing protocols before the procedure.
• Furthermore, the doctor will provide all the information about the post-surgery period, including the expected recovery timeline, potential symptoms to monitor, and overall expectations during the recovery process.
• Written consent is signed by the patient or their family member after they have been provided with information about the surgery.

During surgery

Coronary artery bypass grafting (CABG) can be performed in different ways, with the most common being traditional bypass surgery. During this procedure:

• Before the patient goes into the operating room, the nurse inserts an IV into the forearm or hand to give anesthesia.
• The patient will be under general anesthesia, asleep throughout the operation.
• A chest incision is made, and the breastbone is divided and held open during surgery.
• A heart-lung bypass machine is often used, taking over the heart and lung functions during the procedure.
• The surgery’s duration can range from 3 to 6 hours, depending on the number of arteries requiring bypass.
• In some cases, less invasive approaches (smaller incisions) may be used, where the chest bone is not opened, based on the patient’s risk factors and the recommendations of the surgical team.

After surgery

After coronary artery bypass surgery, a team of doctors will monitor the patient’s well-being and ensure comfort. Upon waking up, the patient might feel sore and disoriented. Here’s what the patient can typically expect:

• The breathing tube remains in the throat until the patient can breathe independently.
• The patient will spend around 1 to 2 days in the intensive care unit, and the total hospital stay duration depends on the recovery and any potential complications. Some patients go home within a week after surgery.
• The doctor’s team closely monitors the patient’s condition, recording breathing and heart rhythm. Frequent temperature checks are conducted.
• IV medications are administered to manage pain and prevent complications like blood clots. The doctor may recommend daily aspirin use if the patient is not already taking it, but this decision will depend on the specific medical needs.
• A supervised program called cardiac rehabilitation helps improve heart health post-surgery. It involves education, counseling, and exercise. The patient will be encouraged to start moving and walking while in the hospital and will continue the rehab program at a medical center.
• After surgery, be vigilant for symptoms like fever, rapid heart rate, chest wound pain, changes in skin color around the wound, or any unusual bleeding or discharge. Contact the doctor if the patient experiences any of these symptoms.
• The patient can usually resume driving, work, and physical activities, including sexual activity, after 4 to 6 weeks with the doctor’s approval. However, recovery can vary from person to person, so consult the doctor for personalized guidance.